Treatment of dark circles under the eyes

Almost all of us at some point in our lives will wake up one day to the horror of Puffiness and Dark Circles under the eyes. These dark areas will make us look tired and even perhaps mildly sinister.

Here are photos of patients with  dark circles treated surgically by Blepharoplasty:

Upper and lower blepharoplasty

Cause of dark circles under the eyes

Darkness may be due to puffy eyelids or an actual increase in the pigmentation of the skin. Some of the causes are:

  • A genetic increase in pigmentation
  • Increased pigmentation after sun exposure
  • Increased pigmentation due to hormonal factors such as pregnancy
  • Bruising after trauma or surgery
  • Medical diseases
  • Swelling of the fat under the eyes with resultant shadowing
  • Dehydration/Alcohol or drug use
  • Loss of fat at rim of orbit with age


Treatment of dark circles

Bleaching creams

These will actually block the production of melanin, a pigment produced by the melanocyte cells in our skin. Normally, melanin is neatly stacked within our melanocyte cells. Skin damaged by the sun or as a reaction to some other stimulus (traumatic, metabolic or hormonal reasons) will have melanin particles dispersed around the skin rather than in the cells. Stopping the production of melanin will eventually clear up skin color. However, since bleaching creams such as Hydroquinone must be used with Retin A (tretinoin) to allow penetration into the cells, some care must be taken. The  eyelid skin is particularly thin, and treatment  can cause dryness, itching and burning.



A home remedy for bleaching is placing slices of potatoes on the eyelids. The sulfur in the potatoes will work to bleach the skin. Haven’t tried it myself though!

Chemical peels

The idea of the chemical peel is based on irritating the skin and allowing for new, more orderly skin growth with melanin pigment in its proper place within the cells. However, chemical peels can actually cause dark circles and make the dark color worse! Pre-treatment with bleaching creams is essential.

Correction of metabolic/hormonal imbalances

Though skin color changes as a result of pregnancy are common, they are rare as a sequel to metabolic diseases. Medical treatment will improve dark circles.


Dehydration will cause the fat around eyes to shrink and lead to the eyeball actually falling back and giving the impression of a darker color around eyes. In reality, it is just light casting a shadow as it hits the bony rim of the orbit. Alcohol will cause dehydration and may cause that bleary-eyed, hungover look.

If persistent, injecting dermal skin fillers into the lines will puff the area up and improve its overall appearance.


Reducing swelling of the eyelids

Any technique to reduce swelling will reduce the swelling of the fat under the eyes and hence decrease the shadow cast by light as it hits the “bag under the eyes.” Sort of the opposite of the dehydrated case!
Reducing swelling under the eyes can be achieved by:

  • Iced compresses
  • Cool cucumber slices (yes—that’s all they’re doing at the spa!)
  • Hemorrhoidal cream, which is actually a steroid used to decrease swelling in the tissue of eyelids


Intense pulsed dye lasers can break up the melanosomes and make them easier for white blood cells to remove.


The most commonly used treatment for dark lines under the eyes is makeup.  It’s easy to apply, relatively inexpensive and has minimal side effects.

Skin dermal fillers

Dermal skin fillers like Belotero, Restalyn, and  Juvederm can be used to fill in the depression or valley of the orbit – cheek junction to improve the appearance of the valley. Radiesse cannot be used here as it is white in color and that can be seen through the thin skin of the lower eyelid.

Eyelid surgery

In cases of persistent fat under the eyes, removal of the fat is necessary. For more information on this surgery, known as blepharoplasty, look here:

Eyelid surgery